24).
Microperimetry, LLVA and BCVA demonstrate limited performance for detecting the earliest onset of late AMD. It remains to be established whether they perform better than current methods designed to enable self-detection of neovascular AMD onset, such as Amsler grid testing.
Microperimetry, LLVA and BCVA demonstrate limited performance for detecting the earliest onset of late AMD. It remains to be established whether they perform better than current methods designed to enable self-detection of neovascular AMD onset, such as Amsler grid testing.To compare the visual outcomes and complication rates of sutureless cannula-based intraocular lens (IOL) scleral (SCILS) fixation performed with 25-gauge (25G) versus 27-gauge (27G) instrumentation.
Retrospective chart review of consecutive cases of eyes without capsular support that underwent SCILS fixation of a three-piece IOL. SCILS fixation was performed by transconjunctival use of either 25G or 27G trochar cannulas. During postoperative follow-up evaluations, visual acuity (VA) and intraocular pressure were measured, and slit lamp and indirect ophthalmoscopy examinations were performed to assess for development of known complications.
A total of 69 eyes underwent 25G (27 eyes) or 27G (42 eyes) SCILS fixation. Mean preoperative logarithm of the minimum angle of resolution (logMAR) VA trended towards improvement from 0.95 ± 0.68 (20/178 Snellen equivalent) to 0.67 ± 0.64 (20/94 Snellen equivalent) for 25G group at 1-year. Similar trend towards VA improvement was seen in 27G group with mean preoperative logMAR VA of 1.43 ± 0.94 (20/538 Snellen equivalent) improving to 0.86 ± 1.00 (20/145 Snellen equivalent) at 1-year. Statistically significant improvement was seen as early as postoperative week one for 27G group (p&lt;0.01), whereas statistically significant worsening was noted at the same time in 25G group (p=0.01). There was a statistically significant reduction in IOL displacement (p=0.01) and need for reoperation (p=0.01) in 27G group.
Compared to 25G SCILS fixation, eyes managed with 27G SCILS fixation experienced more rapid VA improvement. Additionally, there was a lower rate of complications including IOL displacement and need for re-operation.
Compared to 25G SCILS fixation, eyes managed with 27G SCILS fixation experienced more rapid VA improvement. Additionally, there was a lower rate of complications including IOL displacement and need for re-operation.To report a case of vitreous seeding in a medium-sized choroidal melanoma and review the literature.
Observational case report and review of literature for pathogenesis, role of vitreous biopsy, and treatment outcomes.
A case of 57-year-old man diagnosed with vitreous seeding in the left eye 1 year after episcleral brachytherapy for medium-sized choroidal melanoma. The patient was initially diagnosed to have subretinal and vitreous hemorrhage due to rupture of a retinal artery macroaneurysm for which focal laser and intravitreal antivascular endothelial growth factor injections were administered. Over the next 9 months, the vitreous hemorrhage cleared and choroidal melanoma with retinal invasion became evident. One year after brachytherapy, the primary tumor regressed with resolution of surrounding subretinal fluid and hemorrhage. https://www.selleckchem.com/products/Nutlin-3.html However, gradual decline in the visual acuity from 20/50 to 20/500 with increase of pigmented debris over the retinal surface and in the vitreous cavity was noted. A vitreous biopsy confirmed the presence of viable melanoma cells (epithelioid type), and the eye was enucleated. Histopathology showed microscopic persistence of primary tumor with diffuse vitreous seeding.
Vitreous seeding of choroidal melanoma poses a diagnostic and management challenge.
Vitreous seeding of choroidal melanoma poses a diagnostic and management challenge.To evaluate the association between choriocapillaris (CC) flow deficits and structural optical coherence tomography biomarkers and the progression of intermediate age-related macular degeneration (iAMD) to complete retinal pigment epithelial and outer retinal atrophy.
Retrospective analysis of consecutive patients with iAMD with a minimum follow-up of 12 months. Odds ratios of intraretinal hyperreflective foci, hyporeflective drusen cores, subretinal drusenoid deposits, the presence of drusen volume ?0.03 mm3 within a central 3-mm circle, fellow eye with late stage of AMD, and CC flow deficits at baseline and months of follow-up were estimated from logistic regression.
A total of 112 eyes with iAMD were included. Eyes that progressed were significantly more likely to show intraretinal hyperreflective foci, hyporeflective drusen cores, and drusen volume ?0.03 mm3. The CC flow deficit was also significantly greater in eyes that developed complete retinal pigment epithelial and outer retinal atrophy. Intraretinal hyperreflective foci, hyporeflective drusen cores, drusen volume ?0.03 mm3, and higher CC flow deficits were significantly and independently associated with the development of complete retinal pigment epithelial and outer retinal atrophy.
The CC flow deficit was significantly greater in iAMD eyes that progressed to complete retinal pigment epithelial and outer retinal atrophy and remained an independent risk factor when structural optical coherence tomography biomarkers were considered. CC flow deficits may be useful for enhancing risk stratification and prognostication of patients with iAMD.
The CC flow deficit was significantly greater in iAMD eyes that progressed to complete retinal pigment epithelial and outer retinal atrophy and remained an independent risk factor when structural optical coherence tomography biomarkers were considered. CC flow deficits may be useful for enhancing risk stratification and prognostication of patients with iAMD.Electroconvulsive therapy (ECT) remains one of the most effective treatments for major depressive disorder, but uncertainties persist regarding the cognitive tests to include in ECT follow-up. The current study is a systematic review and meta-analysis of the most frequent cognitive side effects after ECT. We also discuss the most common cognitive tests in ECT follow-up. We searched studies published from 2000 to 2017 in English and French language in Pubmed, EBM Reviews, EMBASE, and PsycINFO. Standardized cognitive tests were separated into 11 cognitive domains. Comparisons between cognitive measures included pre-ECT baseline with post-ECT measures at 3 times PO1, immediately post-ECT (within 24 hours after last ECT); PO2, short term (1-28 days); and PO3, long term (more than 1 month). A total of 91 studies were included, with an aggregated sample of 3762 individuals. We found no significant changes in global cognition with Mini-Mental State Examination at PO1. Hedges g revealed small to medium effect sizes at PO2, with individuals presenting a decrease in autobiographical memory, verbal fluency, and verbal memory.